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Debilitating Facial Pain May Be Trigeminal Neuralgia

Dean Hamilton, ARNP

Dean Hamilton, ARNP
ARNP, Swedish Cerebrovascular Center

All pain can be frightening, but when patients describe sharp, electric-type pain in their face, the cause may be Trigeminal Neuralgia, a treatable pain syndrome manifesting as unilateral facial pain that can be severe in intensity. The pain occurs in one or more distributions of the trigeminal nerve. The pain usually lasts for several seconds to several minutes followed by periods of being pain free. Trigeminal neuralgia pain can be triggered by sensory stimuli to the face including talking, brushing teeth, eating, and touching the face. In some cases, there is no trigger. The annual incidence of trigeminal neuralgia is approximately 4 in 100,000. The initial workup for trigeminal neuralgia may include an MRI of the brain to rule out brain tumor or MS plaques.

In many cases, trigeminal neuralgia is caused by compression of the facial nerve most commonly by the superior cerebellar artery or the anterior inferior cerebellar artery, although trigeminal neuralgia can be due to compression by a persistent permanent trigeminal artery or odioectatic basilar artery. Other causes of Trigeminal Neuralgia can include demyelinating disease (such as multiple sclerosis) and tumor. In some cases, the cause of Trigeminal Neuralgia is  ...

Radiosurgery treatment for brain metastases reduces risk of memory loss and improves survival

Sandra S. Vermeulen, MD

When a person has metastatic cancer, the brain is one of the organs that cancer cells can migrate to. If this happens, the condition is called brain metastases. The brain metastases will have the same cancer cell type as the primary cancer, such as lung or breast cancer.

If this occurs, radiation treatment is often used to control these areas of disease. Research is finding that utilizing stereotactic radiosurgery as the initial treatment for people with four or less brain metastases is associated with improved survival and reduced risk of memory loss compared to whole brain radiation. Stereotactic radiosurgery ....

Trigeminal Neuralgia: Face Pain & Treatment Options

Christopher Loiselle, MD

Christopher Loiselle, MD
Radiation Oncologist

October 7th was Trigeminal Neuralgia Awareness Day and for many reading or hearing the stories, like the story on CNN.com, this condition may not be familiar.  However, for those suffering from trigeminal neuralgia, every day can be challenging.

Facial pain in Trigeminal Neuralgia is characterized by episodes of intense pain lasting from a few seconds to hours at a time. The attacks are often described as electric shock like, burning, pressing, crushing,  or shooting pain. Patients describe areas on the face as sensitive to the point that even a gentle breeze of wind can trigger an episode of pain.

Once diagnosed, trigeminal neuralgia can be treated with ...

Life-saving technology and getting the word out about radiosurgery

Erin Kieper

Erin Kieper
Program Development Manager, Swedish Radiosurgery Center

Twice last week I received phone calls from grateful family members thanking us for taking care of their loved ones when treatment options were dwindling. One patient is now 4 years past his CyberKnife treatment for inoperable lung cancer and is going strong and living life to the fullest. The other patient was recently treated and is feeling great and planning a European vacation. Both families are extremely appreciative for the care they received but both voiced frustration that they stumbled upon this treatment option by chance and that we need to do a better job of publicizing the radiosurgery modalities. As the person receiving these calls, I am thrilled to hear how our center has positively impacted so many lives but struggle with how to get the word out to those who may benefit from radiosurgery in the future. So with our patients’ stories fresh in my mind, here is an introduction to radiosurgery.

Stereotactic radiosurgery is targeted radiation therapy delivered to nearly any body part with precision while utilizing real time image guidance. The ....

Acoustic Neuromas & How We Treat Them

Douglas D. Backous, MD

Douglas D. Backous, MD
Medical Director, The Center for Hearing and Skull Base Surgery

Acoustic Neuromas, also known as vestibular schwannoma, is a slow growing  benign tumor on the balance nerve connecting the inner ear to the brain.

This is an uncommon condition, found in roughly 1 in 100,000 people. The most common symptoms include hearing loss, tinnitus (ringing in your ear), and vertigo (a feeling of imbalance). Because these symptoms are present with many conditions, it is important to see your doctor if they persist more than a few weeks. Your healthcare provider will make a referral to an ENT surgeon or to a Neurotologist if they feel you need further evaluation. Neurotology is a sub-specialty of  otolaryngology (ears, nose, and throat) specializing in the neurological conditions of the ears and brainstem (also referred to as skull base surgery. if an acoustic neuroma is suspected). The neurotologist may conduct a clinical evaluation, hearing and balance tests and imaging studies, such as MRI, to make the diagnosis. 

Once diagnosed, there are many options to consider:

  • Observation with a repeat MRI scan in 6 months. If the scan shows no growth,  repeat scanning at annual intervals for 3 years is recommended. If the tumor size is stable, the scan will be repeated after 2 years thereafter. If at any interval the tumor grows, the other treatment options should be considered.
  • Radiosurgery is an option which ...

Treating Arteriovenous Malformations to Remove the Risk of Rupture

David W. Newell, MD

An arteriovenous malformation (AVM) in the brain is a relatively rare condition – occurring in less that 1 percent of the population. It can, however, be neurologically morbid in young adults ages 15 to 20, who are at the greatest risk for hemorrhage and least likely to exhibit symptoms. About 2 to 4 percent of all AVMs each year hemorrhage.

An AVM’s tangled mass of blood vessels, which forms in utero, produces multiple direct connections between arteries and veins without the normal, intervening capillaries. Symptoms often are not present until later in life or until after the AVM ruptures.

A small number of congenital syndromes, such as Sturge-Weber, Rendu-Osler-Weber, ataxia telangiectasia, and Wyburn-Mason, are associated with AVMs. Once formed, extrinsic factors, such as arterial shunting, growth factors and intracranial hemorrhage, may alter the size and shape of an AVM.

The most common types of AVMs are:

International visitors to the Radiosurgery Center

Erin Kieper

Erin Kieper
Program Development Manager, Swedish Radiosurgery Center

The Swedish Radiosurgery Center was a featured stop for the nursing students from Kobe City College of Nursing during their recent visit to Seattle. The students toured the center where they learned about our CyberKnife and Gamma Knife programs.

I was very impressed that the patient care is personalized to respect the needs of every individual. I have a lot of respect for staff who sincerely work with patients regardless of their background and circumstances. We learned the importance of having confidence in our field as medical professionals and the great privilege of serving ones in need.”

- Keiko Kikuchi, RN, PHN, Assistant Professor, Kobe City College of Nursing.

The group learned ...

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